RESUMO
Se presenta el caso de una paciente mujer de 73 años que acude por disnea progresiva, fiebre diurna, hiporexia y cefalea de diez días de evolución. Antecedente de neoplasia ovarica, gastritis crónica y tromboembolia pulmonar. La fiebre continuó a pesar de tratamiento antibiótico convencional. Al examen, se identificó compromiso pulmonar y adenopatías inguinales, estas últimas corroboradas por ecografía de partes blandas. Los cultivos realizados fueron negativos y el estudio radiológico mostró compromiso pleuroparenquimal en base de pulmón izquierdo. La tomogragía abdominal evidenció hepatoesplenomegalia con hipodensidades múltiples (peliosis); la serología fue compatible con Bartonella henselae. La paciente evolucionó favorablemente luego de 72 horas de iniciado en tratamiento con doxiciclina a 100 mg cada doce horas.
This is the case of a 73-year-old female patient who presented with progressive dyspnea, diurnal fever, hyporexia and headache lasting for 10 days. She had a past medical history of an ovarian neoplasia, chronic gastritis and pulmonary thromboembolism. Fever continued despite conventional antibiotic treatment. Her physical examination revealed pulmonary involvement and bilateral inguinal adenopathy; the latter was corroborated with soft tissue ultrasound. Cultures performed were reported as negative and a chest X-ray film showed pleuro-parenchymal involvement in the left pulmonary base. An abdominal CT scan showed hepatosplenomegaly with multiple hypodense images (peliosis); and serological studies were compatible with Bartonella henselae. Doxyciclin 100 mg every 12 hours was started, and the patient started recovering uneventfully 72 hours after therapy was instituted.
